富血小板血浆促进软组织损伤修复的实验研究

目的观察富血小板血浆（platelet-rich plasma,PRP）对犬软组织损伤的修复作用,探讨其促进软组织修复的机制。方法杂种犬4只,体重：18kg～24kg,雌雄不限。随机选择每只犬的一侧后腿的大腿内侧分别制作两个直径为4cm×3cm椭圆形创面和长度为3cm的直线伤口,深及皮下筋膜层,再随机选择一个椭圆形创面和直线伤口为实验创面,用PRP凝胶覆盖创面,对照组创面任其渗血在创面凝固,两组都用3M愈肤膜覆盖损伤处。分别于术后7天、14天、21天、28天通过大体观察和组织学观察对比两侧创伤愈合情况。结果术后7天,对照组创面少许肉芽组织生长,伤口周围有炎症反应;实验组创面清洁,有较多肉芽组织生长,伤口周围无明显炎症反应。术后7～28天,两组的椭圆形创面逐渐缩小,但实验组创面缩小明显并无明显瘢痕;实验直线伤口于术后14～21天完全愈合,无明显瘢痕,对照组可见到明显瘢痕。组织学观察：实验组创面愈合较快,至术后28天,形成比较成熟的皮肤组织,而对照组创面可见到较多瘢痕组织;实验组直线伤口术后14～21天即形成较成熟的皮肤组织,对照组直线形伤口于21～28天形成较成熟的皮肤组织,但瘢痕组织较多。结论 PRP能加快犬软组织损伤的愈合,并能减少瘢痕。

The study of platelet-rich plasma (PRP) in promoting the wound healing of soft tissue

Objective To investigate the effect and mechanism of platelet-rich plasma（PRP） in promoting wound healing of soft tissue in dogs.Methods Four hybrid dogs with weight of 18kg～24kg and either male or female were involved in this study.Two oval-shaped wounds of 4cm×3cm in diameter and two linear wounds of 3cm in length were produced which were deep to the subcutaneous fascia in the inside of one hind thigh of the 4 dogs at random.An oval-shaped and a linear wound was randomly selected as the experimental wound covered with platelet-rich plasma（PRP） gel,the control wound was left blood oozing and coagulating.All of the wounds of the two groups were covered with 3M medical skin membrane.Gross and histopathological observations of the wounds were carried on repectively on 7d,14d,21d,28d and the healing conditions were also compared.Results There were more granulations and less inflammatory reaction in the experimental wounds than those in the control ones 7 days after operation.The oval-shaped wound areas of the two groups gradually reduced during 7～28 days after operaton.However,the experimental wound areas healed up obviously without obvious scar;the linear experimental wound areas closed up completely without obvious scar compared with one in the control group during 7～21 th days after operation.Histological observation： the oval-shaped wound areas of experimental group healed up more quickly and formed mature skin 28 days after operation,while the ones of the control group formed more scars;the lineral wound areas of experimental group healed up 14～21 days after operation,while the ones of the control group healed up with more scars during 21d～28d.Conclusion Platelet-rich plasma（PRP） can significantly promote the healing of soft tissue wounds and reduce the scar formed in dogs.